Prostate Cancer Upgrading, Upstaging Does Not Differ by Race

Researchers have found no significant racial variation in the rates of prostate cancer (PCa) upstaging and upgrading at the time of radical prostatectomy among men with low-risk disease, according to a recent report. African Americans, however, are significantly more likely than other races to have positive surgical margins (PSM).

A team at the University of California San Francisco led by Matthew R. Cooperberg, MD, studied 4,231 patients with low-risk PCa based on initial biopsy findings. All had undergone with RP within 1 year of diagnosis. The group included 3,771 Caucasians, 273 African Americans, and 187 patients of other races.

The overall rate of pathologic upgrading and upstaging was 34% and 13%, respectively, and these rates did not differ significantly by racial group, the investigators reported online ahead of print in European Urology. The upgrading rates were 33%, 34%, and 33% for Caucasians, African Americans, and other races, respectively. The upstaging rates were 13%, 13%, and 16%, respectively. The PSM rate was 31% for African Americans versus 21% and 20% for Caucasians and other races. In multivariate analysis, African Americans were 63% and 41% more likely than Caucasians and other races to have PSM.

Additionally, African-American patients were significantly younger than Caucasians and other races (mean 58.7 years vs. 60.0 and 60.5 years) and more likely to have comorbidities such as hypertension and diabetes.